Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 14 de 14
Filtrar
1.
BMC Pregnancy Childbirth ; 21(1): 4, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33397319

RESUMO

BACKGROUND: Per UNICEF's Nurturing Care Framework, early childhood development (ECD) begins during pregnancy and many lower-resource settings need data to inform their programs for optimal child development. The maternal-fetal relationship can be partly examined via a series of bonding activities called early stimulation behaviors (ESB). This study describes early stimulation behaviors and the associated correlates among pregnant women in Ghana. METHODS: This cross-sectional study used data from a cluster-randomized trial in two districts of Northern Ghana. A total of 374 pregnant women were enrolled at baseline and administered a pre-intervention survey. Communication-related early stimulation behaviors was the primary outcome which was evaluated using three maternal-fetal bonding activities; did the woman self-report touching and/or talking, singing, and/or talking about family to her belly. A generalized estimating equation modified Poisson model was used for the bivariate and multivariable analysis. RESULTS: About half of the participants reported performing communication-related ESB during pregnancy frequently or sometimes. Bivariate analysis revealed that negative life experiences including higher rates of emotional, physical and sexual intimate partner violence (IPV) and having moderate to severe depressive symptoms were associated with women performing early stimulation behaviors more often. In the multivariable model, physical intimate partner violence remained significantly associated with early stimulation behaviors. CONCLUSION: Research on early stimulation behaviors is still in a nascent phase. It is unclear why our results revealed an association between intimate partner violence and early stimulation behaviors; this could reflect a coping mechanism for the expectant mother. Further research is needed to better understand this association and explore potential long-term impacts of early stimulation behaviors during pregnancy on child development. TRIAL REGISTRATION: Clinical Trials # NCT03665246 , August 29, 2018.


Assuntos
Relações Materno-Fetais , Apego ao Objeto , Estimulação Física/métodos , Gestantes , Estimulação Acústica/métodos , Adolescente , Adulto , Estudos Transversais , Feminino , Gana , Humanos , Violência por Parceiro Íntimo/psicologia , Distribuição de Poisson , Gravidez , Gestantes/psicologia , Delitos Sexuais/psicologia , Canto , Apoio Social , Fala , Tato , Adulto Jovem
2.
Int J Gynaecol Obstet ; 150 Suppl 1: 17-24, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33219998

RESUMO

Ghana has made progress in expanding providers in abortion care but access to the service is still a challenge. We explored stakeholder perspectives on task-sharing in abortion care and the opportunities that exist to optimize this strategy in Ghana. We purposively sampled 12 representatives of agencies that played a key role in expanding abortion care to include midwives for key informant interviews. All interviews were audio recorded, transcribed verbatim, and then coded for thematic analysis. Stakeholders indicated that Ghana was motivated to practice task-sharing in abortion care because unsafe abortion was contributing significantly to maternal mortality. They noted that the Ghana Health Service utilized the high maternal mortality in the country at the time, advancements in medicine, and the lack of clarity in the definition of the term "health practitioner" to work with partner nongovernmental organizations to successfully task-share abortion care to include midwives. Access, however, is still poor and provider stigma continues to contribute significantly to conscientious objection. This calls for further task-sharing in abortion care to include medical or physician assistants, community health officers, and pharmacists to ensure that more women have access to abortion care.


Assuntos
Aborto Induzido , Mortalidade Materna , Tocologia/organização & administração , Feminino , Gana , Humanos , Farmacêuticos/organização & administração , Gravidez , Estigma Social
3.
Midwifery ; 83: 102657, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32035341

RESUMO

OBJECTIVE: Rates of maternal and neonatal death remain high in the Global South, especially in Sub-Saharan Africa. In addition, indicators vary significantly by geography. This study aimed to understand what communities in northern Ghana with frequent maternal and newborn deaths or near deaths (near-misses) perceive to be the causes. As part of a larger study, four communities in Ghana's Northern Region were identified as areas with high concentrations of deaths and near-misses of mothers and babies. DESIGN: Stakeholders were interviewed using in-depth interviews (IDIs) and focus-group discussions (FGDs). Field workers conducted 12 FGDs and 12 IDIs across a total of 126 participants. SETTING: This exploratory descriptive study was conducted in the East Mamprusi District in the Northern Region of Ghana, in the communities of Jawani, Nagboo, Gbangu and Wundua. PARTICIPANTS: FGDs were led by trained field workers and attended by traditional chiefs and their elders, members of women's groups, and traditional birth attendants in each of the four study communities. IDIs, or one-on-one interviews, were conducted with traditional healers who manage maternal and neonatal cases, community health nurses, and midwives. MEASUREMENTS AND FINDINGS: Qualitative data were audio-recorded, transcribed, and thematically analyzed using the Attride-Sterling analytical framework. Discussions focused on where blame should be attributed for the negative outcomes of mothers and babies - with blame either being directed at the actions or inactions of the mothers (behavioral), or at the larger factors associated with poverty (situational) that necessitate mothers' behavior. For example, some respondents blamed women for their poor diets, while others blamed the lack of money or household support to buy nutritious foods. Blame was rarely attributed to the fathers despite local gender norms of males being the household decision-makers with regard to spending and care-seeking. KEY CONCLUSIONS: These findings contribute to a small but growing body of literature on the blaming of mothers for their own deaths and those of their newborns - a phenomenon also described in high-income countries - and is supported by blame attribution theories that explain the self-protective nature of victim-blaming. IMPLICATIONS FOR PRACTICE: These results carry important implications for education and intervention design related to maternal and neonatal mortality, including more focused efforts at incorporating men and the larger community. More research is warranted on blame attribution for these adverse outcomes and its effects on the victims.


Assuntos
Mortalidade Fetal/tendências , Mortalidade Materna/tendências , Opinião Pública , Adulto , Idoso , Feminino , Grupos Focais/métodos , Gana , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Tocologia/normas , Tocologia/estatística & dados numéricos , Gravidez , Pesquisa Qualitativa , População Rural/estatística & dados numéricos
4.
Int J Gynaecol Obstet ; 145(3): 343-349, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30874303

RESUMO

OBJECTIVE: To explore basic and comprehensive emergency obstetric service provision across four districts in rural northern Ghana, and whether women were more likely to deliver at facilities with more skilled care. METHODS: Field workers geo-coded all health facilities in East Mamprusi, Sissala East, Kassena Nankana Municipal, and Kassena Nankana West districts, and administered surveys to assess providers and emergency obstetric care available. Data were also prospectively collected on delivery locations of women and neonates who died, or nearly died (near misses), between September 1, 2015 and April 30, 2017. RESULTS: There were 14 physicians for a population of nearly 360 000 women. Six (6%) facilities could provide basic emergency care, and 3 (3%) could provide comprehensive care. Services were distributed unequally, with 6 (67%) of the emergency facilities located in the least populated district. Among the sample of women and neonates who died or nearly died, 175 (39%) delivered at locations unable to provide basic emergency services. CONCLUSION: Access to emergency obstetric and neonatal care was distributed inequitably across these districts, suggesting the need to revisit geographic placement of facilities relative to population. The study also raised the question of how to ensure facilities are equipped to respond to emergencies.


Assuntos
Parto Obstétrico/estatística & dados numéricos , Serviços Médicos de Emergência/provisão & distribuição , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Adulto , Feminino , Gana/epidemiologia , Instalações de Saúde/estatística & dados numéricos , Humanos , Recém-Nascido , Morte Materna/prevenção & controle , Morte Perinatal/prevenção & controle , Gravidez
5.
BMC Pregnancy Childbirth ; 18(1): 3, 2018 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-29291711

RESUMO

BACKGROUND: Twenty years after acknowledging the importance of joint responsibilities and male participation in maternal health programs, most health care systems in low income countries continue to face challenges in involving men. We explored the reasons for men's resistance to the adoption of a more proactive role in pregnancy care and their enduring influence in the decision making process during emergencies. METHODS: Ten focus group discussions were held with opinion leaders (chiefs, elders, assemblymen, leaders of women groups) and 16 in-depth interviews were conducted with healthcare workers (District Directors of Health, Medical Assistants in-charge of health centres, and district Public Health Nurses and Midwives). The interviews and discussions were audio recorded, transcribed into English and imported into NVivo 10 for content analysis. RESULTS: As heads of the family, men control resources, consult soothsayers to determine the health seeking or treatment for pregnant women, and serve as the final authority on where and when pregnant women should seek medical care. Beyond that, they have no expectation of any further role during antenatal care and therefore find it unnecessary to attend clinics with their partners. There were conflicting views about whether men needed to provide any extra support to their pregnant partners within the home. Health workers generally agreed that men provided little or no support to their partners. Although health workers had facilitated the formation of father support groups, there was little evidence of any impact on antenatal support. CONCLUSIONS: In patriarchal settings, the role of men can be complex and social and cultural traditions may conflict with public health recommendations. Initiatives to promote male involvement should focus on young men and use chiefs and opinion leaders as advocates to re-orient men towards more proactive involvement in ensuring the health of their partners.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Homens/psicologia , Cuidado Pré-Natal/psicologia , Adulto , Tomada de Decisões , Características da Família , Pai/psicologia , Feminino , Grupos Focais , Identidade de Gênero , Humanos , Liderança , Masculino , Pessoa de Meia-Idade , Tocologia , Gravidez , Parceiros Sexuais/psicologia , Adulto Jovem
6.
Reprod Health ; 13: 20, 2016 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-26957319

RESUMO

BACKGROUND: While Ghana is a leader in some health indicators among West African nations, it still struggles with high maternal and neonatal morbidity and mortality rates, especially in the northern areas. The clinical causes of mortality and morbidity are relatively well understood in Ghana, but little is known about the impact of social and cultural factors on maternal and neonatal outcomes. Less still is understood about how such factors may vary by geographic location, and how such variability may inform locally-tailored solutions. METHODS/DESIGN: Preventing Maternal And Neonatal Deaths (PREMAND) is a three-year, three-phase project that takes place in four districts in the Upper East, Upper West, and Northern Regions of Ghana. PREMAND will prospectively identify all maternal and neonatal deaths and 'near-misses', or those mothers and babies who survive a life threatening complication, in the project districts. Each event will be followed by either a social autopsy (in the case of deaths) or a sociocultural audit (in the case of near-misses). Geospatial technology will be used to visualize the variability in outcomes as well as the social, cultural, and clinical predictors of those outcomes. Data from PREMAND will be used to generate maps for local leaders, community members and Government of Ghana to identify priority areas for intervention. PREMAND is an effort of the Navrongo Health Research Centre and the University of Michigan Medical School. DISCUSSION: PREMAND uses an innovative, multifaceted approach to better understand and address neonatal and maternal morbidity and mortality in northern Ghana. It will provide unprecedented access to information on the social and cultural factors that contribute to deaths and near-misses in the project regions, and will allow such causal factors to be situated geographically. PREMAND will create the opportunity for local, regional, and national stakeholders to see how these events cluster, and place them relative to traditional healer compounds, health facilities, and other important geographic markers. Finally, PREMAND will enable local communities to generate their own solutions to maternal and neonatal morbidity and mortality, an effort that has great potential for long-term impact.


Assuntos
Saúde do Lactente , Doenças do Recém-Nascido/epidemiologia , Saúde Materna , Complicações na Gravidez/epidemiologia , Saúde da População Rural , Adulto , Pesquisa Participativa Baseada na Comunidade , Países em Desenvolvimento , Projetos de Pesquisa Epidemiológica , Feminino , Gana/epidemiologia , Humanos , Lactente , Saúde do Lactente/etnologia , Mortalidade Infantil , Recém-Nascido , Doenças do Recém-Nascido/etnologia , Doenças do Recém-Nascido/mortalidade , Masculino , Saúde Materna/etnologia , Mortalidade Materna , Projetos Piloto , Gravidez , Complicações na Gravidez/etnologia , Complicações na Gravidez/mortalidade , Estudos Prospectivos , Saúde da População Rural/etnologia , Estados Unidos , United States Agency for International Development
7.
Soc Sci Med ; 133: 59-66, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25841096

RESUMO

Traditional medical systems in low income countries remain the first line service of choice, particularly for rural communities. Although the role of traditional birth attendants (TBAs) is recognised in many primary health care systems in low income countries, other types of traditional practitioners have had less traction. We explored the role played by traditional healers in northern Ghana in managing pregnancy-related complications and examined their relevance to current initiatives to reduce maternal morbidity and mortality. A grounded theory qualitative approach was employed. Twenty focus group discussions were conducted with TBAs and 19 in-depth interviews with traditional healers with expertise in managing obstetric complications. Traditional healers are extensively consulted to manage obstetric complications within their communities. Their clientele includes families who for either reasons of access or traditional beliefs, will not use modern health care providers, or those who shop across multiple health systems. The traditional practitioners claim expertise in a range of complications that are related to witchcraft and other culturally defined syndromes; conditions for which modern health care providers are believed to lack expertise. Most healers expressed a willingness to work with the formal health services because they had unique knowledge, skills and the trust of the community. However this would require a stronger acknowledgement and integration within safe motherhood programs.


Assuntos
Serviços de Saúde Materna , Medicinas Tradicionais Africanas , Tocologia/estatística & dados numéricos , Obstetrícia , Complicações na Gravidez/terapia , Adulto , Países em Desenvolvimento , Feminino , Grupos Focais , Gana , Teoria Fundamentada , Humanos , Masculino , Serviços de Saúde Materna/métodos , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Gravidez , População Rural , Recursos Humanos
8.
Glob Public Health ; 10(9): 1078-91, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25635475

RESUMO

Previous research suggests that care-seeking in rural northern Ghana is often governed by a woman's husband or compound head. This study was designed to explore the role grandmothers (typically a woman's mother-in-law) play in influencing maternal and newborn healthcare decisions. In-depth interviews were conducted with 35 mothers of newborns, 8 traditional birth attendants and local healers, 16 community leaders and 13 healthcare practitioners. An additional 18 focus groups were conducted with stakeholders such as household heads, compound leaders and grandmothers. In this region, grandmothers play many roles. They may act as primary support providers to pregnant mothers, care for newborns following delivery, preserve cultural traditions and serve as repositories of knowledge on local medicine. Grandmothers may also serve as gatekeepers for health-seeking behaviour, especially with regard to their daughters and daughters-in-law. This research also sheds light on the potential gap between health education campaigns that target mothers as autonomous decision-makers, and the reality of a more collectivist community structure in which mothers rarely make such decisions without the support of other community members.


Assuntos
Avós/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Relação entre Gerações , Serviços de Saúde Materno-Infantil/estatística & dados numéricos , Medicinas Tradicionais Africanas/tendências , Mães/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Direitos da Mulher/tendências , Tomada de Decisões , Feminino , Controle de Acesso , Gana/epidemiologia , Humanos , Lactente , Mortalidade Infantil/tendências , Recém-Nascido , Entrevistas como Assunto , Medicinas Tradicionais Africanas/psicologia , Tocologia , Poder Psicológico , Gravidez , Saúde da População Rural
9.
Afr J Reprod Health ; 18(2): 36-45, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25022140

RESUMO

The provision of maternal and neonatal health care in rural northern Ghana is pluralistic, consisting of traditional and allopathic providers. Although women often use these providers interchangeably, important differences exist. This study explored the differences in approaches to maternal and neonatal care provision by these two different types of providers. This research was part of the Stillbirth and Neonatal Death Study (SANDS), conducted in northern Ghana in 2010. Trained field staff of the Navrongo Health Research Centre conducted in-depth interviews with 13 allopathic and 8 traditional providers. Interviews were audio-recorded, transcribed, and analyzed using in vivo coding and discussion amongst the research team. Three overarching themes resulted: 1) many allopathic providers were isolated from the culture of the communities in which they practiced, while traditional providers were much more aware of the local cultural beliefs and practices. 2) Allopathic and traditional healthcare providers have different frameworks for understanding health and disease, with allopathic providers relying heavily on their biomedical knowledge, and traditional providers drawing on their knowledge of natural remedies. 3) All providers agreed that education directed at pregnant women, providers (both allopathic and traditional), and the community at large is needed to improve maternal and neonatal outcomes. Our findings suggest that, among other things, programmatic efforts need to be placed on the cultural education of allopathic providers.


Assuntos
Cultura , Serviços de Saúde Materna/organização & administração , Serviços de Saúde Rural/organização & administração , Feminino , Gana , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Recém-Nascido , Medicinas Tradicionais Africanas , Gravidez , Saúde da Mulher
10.
Matern Child Health J ; 18(1): 109-119, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23423857

RESUMO

To explore the impact of social factors on place of delivery in northern Ghana. We conducted 72 in-depth interviews and 18 focus group discussions in the Upper East Region of northern Ghana among women with newborns, grandmothers, household heads, compound heads, community leaders, traditional birth attendants, traditional healers, and formally trained healthcare providers. We audiotaped, transcribed, and analyzed interactions using NVivo 9.0. Social norms appear to be shifting in favor of facility delivery, and several respondents indicated that facility delivery confers prestige. Community members disagreed about whether women needed permission from their husbands, mother-in-laws, or compound heads to deliver in a facility, but all agreed that women rely upon their social networks for the economic and logistical support to get to a facility. Socioeconomic status also plays an important role alone and as a mediator of other social factors. Several "meta themes" permeate the data: (1) This region of Ghana is undergoing a pronounced transition from traditional to contemporary birth-related practices; (2) Power hierarchies within the community are extremely important factors in women's delivery experiences ("someone must give the order"); and (3) This community shares a widespread sense of responsibility for healthy birth outcomes for both mothers and their babies. Social factors influence women's delivery experiences in rural northern Ghana, and future research and programmatic efforts need to include community members such as husbands, mother-in-laws, compound heads, soothsayers, and traditional healers if they are to be maximally effective in improving women's birth outcomes.


Assuntos
Parto Obstétrico/tendências , Relações Familiares , Instalações de Saúde/estatística & dados numéricos , Hierarquia Social , Parto Domiciliar/tendências , Apoio Social , Atitude Frente a Saúde , Parto Obstétrico/economia , Parto Obstétrico/psicologia , Feminino , Grupos Focais , Gana , Instalações de Saúde/economia , Instalações de Saúde/tendências , Acessibilidade aos Serviços de Saúde , Parto Domiciliar/economia , Parto Domiciliar/psicologia , Humanos , Entrevistas como Assunto , Tocologia/métodos , Tocologia/tendências , Gravidez , Pesquisa Qualitativa , Religião e Medicina , Mudança Social
11.
Midwifery ; 30(2): 262-8, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23790959

RESUMO

OBJECTIVE: to explore community and health-care provider attitudes towards maltreatment during delivery in rural northern Ghana, and compare findings against The White Ribbon Alliance's seven fundamental rights of childbearing women. DESIGN: a cross-sectional qualitative study using in-depth interviews and focus groups. SETTING: the Kassena-Nankana District of rural northern Ghana between July and October 2010. PARTICIPANTS: 128 community members, including mothers with newborn infants, grandmothers, household heads, compound heads, traditional healers, traditional birth attendants, and community leaders, as well as 13 formally trained health-care providers. MEASUREMENTS AND FINDINGS: 7 focus groups and 43 individual interviews were conducted with community members, and 13 individual interviews were conducted with health-care providers. All interviews were transcribed verbatim and entered into NVivo 9.0 for analysis. Despite the majority of respondents reporting positive experiences, unprompted, maltreatment was brought up in 6 of 7 community focus groups, 14 of 43 community interviews, and 8 of 13 interviews with health-care providers. Respondents reported physical abuse, verbal abuse, neglect, and discrimination. One additional category of maltreatment identified was denial of traditional practices. KEY CONCLUSIONS: maltreatment was spontaneously described by all types of interview respondents in this community, suggesting that the problem is not uncommon and may dissuade some women from seeking facility delivery. IMPLICATIONS FOR PRACTICE: provider outreach in rural northern Ghana is necessary to address and correct the problem, ensuring that all women who arrive at a facility receive timely, professional, non-judgmental, high-quality delivery care.


Assuntos
Atitude do Pessoal de Saúde , Parto/psicologia , Assistência Perinatal , Estudos Transversais , Feminino , Grupos Focais , Gana , Humanos , Entrevistas como Assunto , Gravidez , População Rural
12.
Artigo em Inglês | AIM | ID: biblio-1258504

RESUMO

The provision of maternal and neonatal health care in rural northern Ghana is pluralistic, consisting of traditional and allopathic providers. Although women often use these providers interchangeably, important differences exist. This study explored the differences in approaches to maternal and neonatal care provision by these two different types of providers. This research was part of the Stillbirth and Neonatal Death Study (SANDS), conducted in northern Ghana in 2010. Trained field staff of the Navrongo Health Research Centre conducted in-depth interviews with 13 allopathic and 8 traditional providers. Interviews were audio-recorded, transcribed, and analyzed using in vivo coding and discussion amongst the research team. Three overarching themes resulted: 1) many allopathic providers were isolated from the culture of the communities in which they practiced, while traditional providers were much more aware of the local cultural beliefs and practices. 2) Allopathic and traditional healthcare providers have different frameworks for understanding health and disease, with allopathic providers relying heavily on their biomedical knowledge, and traditional providers drawing on their knowledge of natural remedies. 3) All providers agreed that education directed at pregnant women, providers (both allopathic and traditional), and the community at large is needed to improve maternal and neonatal outcomes. Our findings suggest that, among other things, programmatic efforts need to be placed on the cultural education of allopathic providers. (Afr J Reprod Health 2014; 18[2]: 36-45)


Assuntos
Cultura , Atenção à Saúde , Gana , Saúde Materna , Bem-Estar Materno , Medicinas Tradicionais Africanas , População Rural
13.
BMC Pregnancy Childbirth ; 12: 76, 2012 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-22857600

RESUMO

BACKGROUND: Good nutrition is essential for increasing survival rates of infants. This study explored infant feeding practices in a resource-poor setting and assessed implications for future interventions focused on improving newborn health. METHODS: The study took place in the Kassena-Nankana District of the Upper East Region of northern Ghana. In-depth interviews were conducted with 35 women with newborn infants, 8 traditional birth attendants and local healers, and 16 community leaders. An additional 18 focus group discussions were conducted with household heads, compound heads and grandmothers. All interviews and discussions were audio taped, transcribed verbatim and analyzed using NVivo 9.0. RESULTS: Community members are knowledgeable about the importance of breastfeeding, and most women with newborn infants do attempt to breastfeed. However, data suggest that traditional practices related to breastfeeding and infant nutrition continue, despite knowledge of clinical guidelines. Such traditional practices include feeding newborn infants water, gripe water, local herbs, or traditionally meaningful foods such as water mixed with the flour of guinea corn (yara'na). In this region in Ghana, there are significant cultural traditions associated with breastfeeding. For example, colostrum from first-time mothers is often tested for bitterness by putting ants in it - a process that leads to a delay in initiating breastfeeding. Our data also indicate that grandmothers - typically the mother-in-laws - wield enormous power in these communities, and their desires significantly influence breastfeeding initiation, exclusivity, and maintenance. CONCLUSION: Prelacteal feeding is still common in rural Ghana despite demonstrating high knowledge of appropriate feeding practices. Future interventions that focus on grandmothers and religious leaders are likely to prove valuable in changing community attitudes, beliefs, and practices with regard to infant nutrition.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Aleitamento Materno/psicologia , Ciências da Nutrição Infantil , Cultura , Família , Feminino , Grupos Focais , Gana , Comportamentos Relacionados com a Saúde , Humanos , Recém-Nascido , Masculino
14.
BMC Pregnancy Childbirth ; 12: 50, 2012 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-22703032

RESUMO

BACKGROUND: Knowledge, attitudes and practices of community members and healthcare providers in rural northern Ghana regarding clean delivery are not well understood. This study explores hand washing/use of gloves during delivery, delivering on a clean surface, sterile cord cutting, appropriate cord tying, proper cord care following delivery, and infant bathing and cleanliness. METHODS: In-depth interviews and focus group discussions were audiotaped, transcribed, and analyzed using NVivo 9.0. RESULTS: 253 respondents participated, including women with newborn infants, grandmothers, household and compound heads, community leaders, traditional birth attendants, and formally trained health care providers. There is widespread understanding of the need for clean delivery to reduce the risk of infection to both mothers and their babies during and shortly after delivery. Despite this understanding, the use of gloves during delivery and hand washing during and after delivery were mentioned infrequently. The need for a clean delivery surface was raised repeatedly, including explicit discussion of avoiding delivering in the dirt. Many activities to do with cord care involved non-sterile materials and practices: 1) Cord cutting was done with a variety of tools, and the most commonly used were razor blades or scissors; 2) Cord tying utilized a variety of materials, including string, rope, thread, twigs, and clamps; and 3) Cord care often involved applying traditional salves to the cord - including shea butter, ground shea nuts, local herbs, local oil, or "red earth sand." Keeping babies and their surroundings clean was mentioned repeatedly as an important way to keep babies from falling ill. CONCLUSIONS: This study suggests a widespread understanding in rural northern Ghana of the need for clean delivery. Nonetheless, many recommended clean delivery practices are ignored. Overarching themes emerging from this study included the increasing use of facility-based delivery, the disconnect between healthcare providers and the community, and the critical role grandmothers play in ensuring clean delivery practices. Future interventions to address clean delivery and prevention of neonatal infections include educating healthcare providers about harmful traditional practices so they are specifically addressed, strengthening facilities, and incorporating influential community members such as grandmothers to ensure success.


Assuntos
Parto Obstétrico/normas , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Adulto , Agentes Comunitários de Saúde , Feminino , Grupos Focais , Gana , Desinfecção das Mãos , Comportamentos Relacionados com a Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Higiene , Tocologia , Roupa de Proteção , População Rural
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA